<!DOCTYPE html>
<html>
<head>
	<meta charset="utf-8"/>
	<meta name="viewport" content="width=device-width,initial-scale=1.0,maximum-scale=1.0,user-scalable=no"/>
	<meta name="misapplication-tap-highlight" content="no"/>
	<meta name="HandheldFriendly" content="true"/>
	<meta name="MobileOptimized" content="320"/>
	<title>医护e家</title>
	<link href="../public/css/weui.min.css" rel="stylesheet" type="text/css" />
	<link href="../public/css/jquery-weui.css" rel="stylesheet" type="text/css" />
	<link href="../public/css/base.css" rel="stylesheet" type="text/css" />
	<link href="../public/css/app/detail/visiter_add.css" rel="stylesheet" type="text/css" />
</head>
<body>
<!-- header -->
<div class="header">
	<div class="l-icon icon">
		<a href="javascript:history.back(-1);" class="black"></a>
	</div>
	<div class="title">新建就诊人</div>

</div>

<!-- main -->
<div class="main">
	<div class="tips">*请确保就诊人信息真实准确，一担创建成功，不允许修改！</div>
	<div class="list">
		<ul class="item">
			<li class="name">
				姓名：
			</li>
			<li class="content">
				<input type="text" class="i100" placeholder="请输入真实姓名" />
			</li>
		</ul>
		<ul class="item arrow">
			<li class="name">
				证件类型：
			</li>
			<li class="content">
				<input type="text" id="cardType" readonly  class="i100" placeholder="身份证" />
			</li>
		</ul>
		<ul class="item">
			<li class="name">
				证件号：
			</li>
			<li class="content">
				<input type="text" class="i100" placeholder="输入证件号" />
			</li>
		</ul>
		<ul class="item arrow">
			<li class="name">
				性别：
			</li>
			<li class="content">
				<input type="text" readonly id="sex" class="i100" placeholder="请选择" />
			</li>
		</ul>
		<ul class="item arrow">
			<li class="name">
				出生日期：
			</li>
			<li class="content">
				<input type="text" readonly id="data"  class="i100" placeholder="请选择" />
			</li>
		</ul>
		<ul class="item">
			<li class="name">
				手机号：
			</li>
			<li class="content">
				<input type="number" disabled="disabled" class="i100" placeholder="输入手机号码" />
			</li>
		</ul>
		<ul class="item arrow">
			<li class="name">
				与本人关系：
			</li>
			<li class="content">
				<input type="text" id="nexus"  class="i100" placeholder="选择关系" />
			</li>
		</ul>

		<ul class="item arrow">
			<li class="name">
				现居住地：
			</li>
			<li class="content">
				<input type="text" id="city"  class="i100" placeholder="选择地区" />
			</li>
		</ul>

	</div>
	<div class="fromBtn">
		<a href="visiter.html">提交</a>
	</div>
</div>




<!-- jquery引入 -->
<script type="text/javascript" src="../public/js/jquery/jquery-2.1.4.js"></script>
<!-- weui -->
<script type="text/javascript" src="../public/js/jquery/jquery-weui.js"></script>
<script type="text/javascript" src="../public/js/jquery/city-picker.js"></script>
<script type="text/javascript" src="../public/js/common.js"></script>
<script type="text/javascript" src="../public/js/data/detail/visiter_add.js"></script>
</body>
	
</html>